(Arizona Daily Star

Saturday, December 28, 2002

Doctors ponder high incidence, possible causes

So, why is there a near-epidemic of this thing called ADHD in our children today?

What's driving our kids to distraction?

"When I was in grade school, back in the '50s, I never heard of Ritalin. I don't even remember disruptive kids in class, " said Dr. Hunter Yost, a Tucson physician who treats the problem with non- drug alternative approaches.

"But maybe they were there?"

They were.

For more than a century, physicians and others have been trying to come up with a term for that small but consistent percentage of children whose behavior is so hyper, aggressive, impulsive and out of control that they do harm to themselves and those around them.

"Minimal brain dysfunction" or "minimal brain damage" this was called 50 or 60 years ago. By the 1980s the description was softened to "attention-deficit-hyperactivity disorder" - no longer labeling a kid brain-damaged - and it stuck.

With that formal medical diagnosis, and the development of stimulant drugs to treat it, attention to the problem skyrocketed. No longer were these struggling youngsters just dropping out of school, doomed to be underachievers, underemployed and, too often, eventually imprisoned.

Known in the vast majority of the cases to be genetically based - inherited and passed down in certain families - the disorder is linked to a gene that some experts believe evolved over eons of time to help humans survive in more threatening eras.

And Americans - who had to conquer and settle a huge and relatively new country - may be hard-wired for this "response- ready" gene.

"What perplexed me was that ADHD clearly happens a lot more when people are exposed to stress and a sense of danger," said Tucson child psychologist Dennis Embry.

"That suggests it might be an evolutionary mechanism - a gene mutation that produces hyperactivity, novelty-seeking, extroversion - all traits that enabled us to take the risks needed to settle a new country, build cities, explore a planet. ADHD actually makes sense under threatening conditions. But it wreaks havoc in the classroom."

Though genetics control most of this, there are a small percentage of cases, about 15 percent, that doctors believe are triggered by external, environmental factors - an insult or toxic exposure during pregnancy, a difficult birth, child abuse in the home, even the overstimulation of the constantly flashing images on our televisions, movies and electronic games.

Smoking tobacco and heavy drinking during pregnancy have been named as suspects.

Yost believes a known deficiency of omega-3 fatty acids - a nutrient vital to fetal brain development and found in cold-water fish - in the breast milk of U.S. women may be contributing to the problem.

Although over-amped, hyperactive kids apparently have always been with us, the problem is indeed increasing today, Embry believes.

"The chemicals in the brain that regulate ADHD turn off or on as a result of human interaction, and that's what changed," he said.

"We know that if you massage a child, if you say kind words to and praise a child, the ADHD behaviors will go down. But that is happening less and less in families today. Children get less time with their hard-working parents than ever before, at any time in history.

"The whole world is acting less friendly with children now, we are spending less time cuddling and touching them, and human violence everywhere is up.